Hello, Ola, Kumusta Kayong Lahat

1. Hello, Ola, Kumusta Kayong Lahat

2. Don Dionisi RN, M.S. CNOR October 22,2010 Philippine Nurses Association of Texas Cameron County, Inc

6. DowntownBrownsville1950

7. Engaging Nurses’ Roles to Make a DifferenceWhat does this mean?

8. Selective operational Leadership Practices that Engage Nurses’ Roles? • WHO • WHAT • WHEN • WHERE

12. Downtown Brownsville1950

13. Let’s Explore Nursing Roles by understanding the complex make up of our profession • Role Classification • Clinical Autonomy • Competency in Nursing Practice • Role Modeling • Clear Communication • Organizational Skills • Patient Rounding • Interdisciplinary Communication • Nurse Manager Support

14. Clinical Autonomy(Don’s Definition) Freedom of a nurse or nurses to make an independent decision(s) about the nursing practice that created the best outcomes possible for the patient through interdisciplinary communication

15. Role Classification • RN, • LVN, • Nursing Assistant

16. Competency in Nursing Practice Is Largely based on Experience & Education

17. Role Modeling We all emulate behavior and Roles learned from others.

18. Clear Communication Allows the message to be sent in a manner that is open minded & allows for questions and clarifications.

19. Organizational Skills Is a must – also learned behaviors and efficiencies and the Skill Sets learned over years of nursing practice.

20. Patient Rounding A new concept that is replacing taped reports.

21. Interdisciplinary Communication Occurs with patient rounding and then coordination can improve patient outcomes and autonomy finally beginning to emerge.

22. Let’s Focus on theNursing Manager’s Support • Never micro manage • Need to be supportive of a nurse’s independent decision Making practice • Assigns patients to the team member based on patient acuity • Assigns patients based on practioner’s ability to care for that patient. • Team a novice nurse up with a seasoned nurse

23. Let’s Look Deeper into the Nursing Manager Support? • Participative Decision Making Process? • Input? • Decisions? • Shared Governance?

24. Participative Decision Making Process is essentional to autonomy. • Must know the difference between oppressive and paternalistic management styles. • Oppressive management is very formal & structured / Black & White • Paternalistic system is the same except it is done in a nicer manner. • Decisions that are arrived at with staff input have a greater chance of being successful. • Shared Governance is a form of Participative Decision Making

25. Shared Governance • Can be controlling • Can be too unstructured • Too much control • Too little control

26. * SCIP / CORE Measures Decision Remove the Foley Day 1? Day 2 ?”

27. * Joint Commission “Time Out” Policy • Understanding Regulatory Influences • CMS Rules & Regulations • JC • OSHA • APIC • Sacred Cows??????

28. As you can tell nursing roles are starting to get complicated so……… what do we do now??

29. We explore…..and explore…… • Skill set by Nursing Roles • Nursing Types • Management Styles / Roles • Stressors in our Roles • Generational Perspectives

30. Skills set by Nursing Roles To many skill sets to describe

31. Nursing Areas of Practice Skills sets for each area of nursing OR • ER • ICU • Cath lab • Etc.

32. Management Styles / Roles There are 8 major management functions that I want to address: • Planning • Organization • Staffing • Directing issues • Coordination Process • Controlling Process • Reporting & Recording • Budget aspect of management

33. Stressors in our Roles • Time • Reality of nursing vs. your dream of nursing • Worn out / Burned out • Getting out vs. staying in

34. Generational Perspectives • Veteran Generation 1920 -1945 • Baby Boomers 1945 -1960 • Generation X 1960 – 1980 • Millennial Generation 1980 - 2000

35. So when should delegation occur? When all of these practice standards have been met!

36. Okay so when is it time to delegate?

37. When do you apply Selective Operational Leadership Practices? When are they easy? • Communication occurs • Clinical Autonomy is Present • Role Clarification is known • Competency is there • Skill sets are present • Common Sense prevails

38. Done , Tapos NaQuestions??????